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Randomised controlled trial
Symptomatic carotid stenosis: relative to endarterectomy, stenting increases short-term risk of stroke or death in those aged over 70 years but not in younger patients
  1. Martin Wiesmann
  1. Department of Neuroradiology, Technical University of Aachen (RWTH), Aachen, Germany
  1. Correspondence to Martin Wiesmann
    Klinik fuer Neuroradiologie, Universitaetsklinikum Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany; mwiesmann{at}ukaachen.de

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Context

Carotid artery stenosis causes up to 10% of all ischaemic strokes. Carotid endarterectomy (CEA) was introduced in the early 1950s and is an effective surgical treatment to prevent stroke. Carotid stenting (CAS) was introduced as a treatment to prevent stroke in 1994. Since then, both methods have been compared in a considerable number of studies. Three randomised controlled trials aiming to compare the outcome after CAS with CEA have been published in the last 4 years.1,,3 Two of the three studies suggested a higher procedural risk in CAS. However, these studies were statistically underpowered to answer the question of whether stenting might be a safe alternative to endarterectomy in specific patient subgroups.4 The present study pooled the data from these three trials and performed a meta-analysis.

Methods

The authors performed a preplanned meta-analysis of individual patient data from the following three randomised controlled trials: EVA-3S, …

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